Provider Demographics
NPI:1356160337
Name:PARKINSON, MITCHELL JAY (RN)
Entity type:Individual
Prefix:MR
First Name:MITCHELL
Middle Name:JAY
Last Name:PARKINSON
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:519 AVENIDA CESAR E CHAVEZ
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64108-2133
Mailing Address - Country:US
Mailing Address - Phone:888-913-1910
Mailing Address - Fax:
Practice Address - Street 1:519 AVENIDA CESAR E CHAVEZ
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64108-2133
Practice Address - Country:US
Practice Address - Phone:888-913-1910
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-07
Last Update Date:2024-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2023024782163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse